The unexpected release of Andrei Sakharov from forced exile in Gorky within days of the death, under harrowing circumstances, of the writer Anatoly Marchenko, who had been held in the infamous Chistopol prison, raises in particularly striking form the question of the future of internal dissent in the Soviet Union.

Despite the contradictory nature of recent events, about which much is still unknown, there is a temptation to be optimistic. When Dr. Sakharov returned to Moscow, the studios of Soviet television were made available to him for an interview with American correspondents. Besides Dr. Sakharov, the poet Irina Ratushinskaya and the Crimean Tatar leader, Mustafa Dzhemiliev, have been released from Soviet labor camps, and Soviet officials have hinted that the largescale liberation of political prisoners is imminent.

Nonetheless, optimism should be tempered with realism. The euphoria created by the release of Dr. Sakharov conveniently smothered nascent outrage over the death of Marchenko; and Marchenko was not the first but rather the seventh wellknown Soviet political prisoner to die of medical neglect since the accession of Mikhail Gorbachev to power twenty-three months ago. There were only five such deaths under Gorbachev’s two predecessors, Andropov and Chernenko, and only one death in the last years of the Brezhnev period when political prisoners who were known in the West, no matter how mistreated, were almost never allowed to die in the camps.

In truth, the situation is uncertain, and because of this, attention has now concentrated on Anatoly Koryagin, the Soviet psychiatrist who has been nominated for the Nobel Peace Prize and is in emaciated physical condition in the Perm 35 camp for political prisoners about 700 miles east of Moscow.

Just as the next few months will tell whether Gorbachev is serious about improving the lot of political prisoners it may also be the period during which, for purely physical reasons, it will become clear whether Dr. Koryagin, who has undertaken repeated hunger strikes, can survive. In his most recent notes, smuggled out of the camp, Dr. Koryagin said that Khasanov, the head of the section where he is being held, told him, “You’ll die like a dog here,” and his wife, Galina, whom I met in Moscow in June, said, “With his character, I’m afraid that if he does not get out of there soon, he won’t survive. He is not going to make any compromises.”

I have more than an academic interest in the matter because I knew Dr. Koryagin well in the Soviet Union and consider him a close friend. More to the point, I have no doubt that he is one of the most important Soviet political prisoners. His readiness to state publicly in 1979 and 1980 that political prisoners in Soviet psychiatric hospitals were sane had an important effect on the decisions of national psychiatric associations to demand the expulsion of the Soviet Union from the World Psychiatric Association (WPA). His arrest, which presented the world with the spectacle of a psychiatrist being arrested for his diagnoses, made the Soviet Union’s expulsion from the WPA a virtual certainty. To avoid this humiliation, the Soviets resigned in January 1983, in the first case of the Soviet Union ever being forced to leave an international body for failure to respect its rules.

Soviet conditions alter our perspective and often render irrelevant our familiar political categories. This is clearly evident in the case of Dr. Koryagin. A man of neither the “left” nor the “right,” he defended the truth for its own sake and, as subsequent events have shown, he is ready to die for it. In this sense, he has proved himself to be a political man in the original Greek sense; guided by his perception of the truth and, even under totalitarian conditions, revealing his distinctive character through action and speech.

Anatoly Koryagin’s determination to live truthfully was already apparent to those around him in the mid-1970s when he worked in a regional psychiatric hospital in Poimo-Tinskaya, a small Siberian city south of Krasnoyarsk. The local doctors told Yuri Belov, who was exiled there, that no one was a match for him in erudition and “he opened our eyes to many things.” The incident which set his course in life, however, occurred in the summer of 1977 in the regional psychiatric clinic in Kyzyl in Siberia, where he had become the deputy head doctor.

An army major was brought to the hospital following an argument with his superiors. The major had threatened to commit suicide and set a date for doing so. That he had been put in a psychiatric hospital after a nonviolent incident meant that the KGB expected a diagnosis that he was insane. Koryagin, after examining him and listening to his explanations, pronounced him sane. Koryagin’s finding did not protect the major. Another psychiatrist made the required diagnosis with the result that the officer was treated with drugs in the hospital where Koryagin worked. But the incident convinced Koryagin that he had to do something to combat the abuse of psychiatry.


As Koryagin explained it to me, “I knew that cases like that of the major were neither rarities nor accidents but, in fact, the rule, and my doctor’s conscience led me to challenge this insofar as, by my calling, I was obliged to restore health and not to ruin it.”

Koryagin moved to Kharkov in the Ukraine where he was hired as a consultant at the Kharkov regional psychiatric clinic. In 1979, he learned from the foreign radio broadcasts about the existence of a “working commission” which had been established by dissidents to combat the political abuse of psychiatry. He went to Moscow and told Felix Serebrov, one of the commission members, “I want to be of use to you.”

In late 1979, Koryagin became a psychiatric consultant to the working commission and, in January 1980, after the emigration of the Moscow psychiatrist Dr. Alexander Voloshanovich, he became its only consultant. He compiled seventeen case histories of psychiatric abuse which were sent for investigation to the International Association on the Political Use of Psychiatry (IAPUP), which passed them on to the member societies of the World Psychiatric Association.

Among the persons who had been put in psychiatric hospitals but were diagnosed by Koryagin as sane were Anatoly Butko, a gynecologist who tried to swim across the Black Sea to Turkey, Lev Pribytkov, a former Communist who renounced his Soviet citizenship, Angela Paskauskiene, who circulated Lithuanian nationalist leaflets, Vladimir Kishkun, a Seventh-Day Adventist who was beaten by drunken coworkers for celebrating Saturday as a feast day, and most fateful of all, Alexei Nikitin, a coal miner who had led a workers’ protest in Donetsk.

During the months that he examined the victims of psychiatric repression, Koryagin traveled frequently to Moscow and it was there, at the apartment of Felix Serebrov, that I met him for the first time. What struck me first was that he was unusually handsome. He was tall and broad-shouldered with sandy hair, a high forehead, and intelligent eyes; the immediate charm of his appearance was complemented by an obviously sincere manner. When he told me that he lived not in Moscow but in the provincial city of Kharkov, where he was vulnerable to any provocation by the KGB, I was struck by his courage.

After that first meeting, Koryagin and I met every time that he came to Moscow and on one particular quiet Sunday afternoon, we gathered with Nikitin at the apartment of Serebrov.

I was trying to learn about the internal life of the Soviet Union and, at my request, Koryagin and Nikitin, who had just been released from the Dnepropetrovsk Special Psychiatric Hospital, described the reasons for the absence of strikes in the Soviet Union. They said that because the Soviet worker is dependent on the bosses of his factory not only for his job but also for his apartment and his access to goods and because decent working conditions are assigned on the basis of “loyalty,” management is able to form special brigades in every factory made up of workers, known as “activists,” who will defend the interests of management in return for privileges. The activists, they said, are detested by the other workers, but the special brigades are essential to the bosses because their creation splits the workforce into two mutually distrustful parts and destroys in advance the possibility of solidarity among workers, which is basic to a successful strike.

The conversation turned to other topics. Koryagin said that, in his opinion, there were two moments in history when fate had been unkind to Russia. These were the October Revolution and the assassination of Czar Alexander II in 1881 on the eve of the implementation of reforms that would have broadened the base of the monarchy.

He spoke about the way people’s patriotism is exploited in the Soviet Union. “The natural feelings of a person,” he said, “are for his language, his culture, his people, and his family. But on top of this base of natural feelings, the regime adds the artificial symbolism of this system. The average citizen can’t work it out. He doesn’t know where his feelings for his people end and his forced allegiance to the system begins.”

Koryagin and I stayed in touch, but from the day that we met at Serebrov’s apartment with Nikitin, our friendship was affected by the relationship of both of us to Nikitin who, unintimidated by four years in the Dnepropetrovsk Special Psychiatric Hospital, was now planning to organize an independent trade union. He suggested that I accompany him to Donetsk to write about the conditions for Soviet workers in the Donbas coal mines. I warned Nikitin about the risks involved, but in the end I went with him to Donetsk where we spent three days talking to the coal miners about their lives.


Shortly after I returned to Moscow, I learned that KGB agents had burst into Nikitin’s room and injected him with a drug, then had wrapped him in a blanket and thrown him into a waiting car. Unsettled by the news, I left Moscow for Kharkov to meet with Koryagin.

At this point, events began to unfold with a certain grim inevitability. I met Koryagin in his apartment in Kharkov and asked him if he wanted to state publicly that Nikitin was sane, reminding him, at the same time, of the risks for him. He nodded his head vigorously, and said, “Definitely.”

After the interview, in which Koryagin repeated for the record that on the basis of his examination, Nikitin did not suffer from any mental illness, he walked me to the main road to catch a cab. It was an icy, crystalline night and we were obviously being followed. As I got into the cab, Koryagin gave me the address of an uncle of his whom he thought was living in Sacramento, California. I was leaving for the United States in a week for a brief trip and I promised to try to get in touch with him. “When you see him,” Koryagin said, “just tell him that I’m on the right path.”

Koryagin was arrested four weeks later.

In the six years since his arrest, when he was taken off the Kharkov-to-Moscow train at Belgorod, Koryagin has gone through an ordeal with few parallels even in the grim history of the Gulag. After his wife Galina last saw him through the glass partition during a two-hour meeting in the Chistopol prison in September 1983, she described him as reduced to a “starving bag of water,” as a consequence of his six-month hunger strike. He has spent three years in solitary confinement, a total of two years on hunger strikes being fed artificially, and six months in the punishment cell, thinly clad, with temperatures kept at about 50 degrees and punitive rations of reprocessed bread and water every other day. The reason for such mistreatment is that the authorities have undertaken an intensive effort to force Koryagin to recant and he has responded with hunger strikes, a prisoner’s only form of self-defense.

Koryagin today is in desperate physical condition and those who know him wonder how, in light of the abuse he has taken, he has been able to survive as long as he has. Nonetheless, his defense of the victims of psychiatric repression has had considerable effect.

The Soviet Union tries to depict itself as a country “like any other.” Its forced resignation from the World Psychiatric Association in 1983, partially as a result of Dr. Koryagin’s evidence, showed that this was not the case in the critical matter of the definition of sanity. It also raised the possibility that other international organizations may one day wish to follow the WPA’s example and begin to treat the Soviet Union in a manner that is consistent with the way it actually behaves.

Quite aside from these international repercussions, Koryagin gave hope to the humble and often desperate victims of psychiatric repression who came to him for help. One of his “patients” told Galina after his arrest, “He gave me my life back. Because of what he did, it became worthwhile to live again.”

The Soviet Union has shown an interest in being readmitted to the WPA and so the efforts to force Koryagin to recant are undoubtedly continuing, but it is unlikely that Koryagin will finally give in. At a meeting with Galina in Perm in 1981 he said, “What I have done, I did because I could not do otherwise. Only in this way can I preserve myself as a man, my human dignity. If they even begin to break me, it will be the end, I could not live with myself.”

As I think back now about our early meetings and the events that followed them, it seems to me that despite the political consequences of Koryagin’s actions, the real force behind his human rights activity was not any specific political goal but the defense of human dignity—his own and that of others. In his latest prison notes, Koryagin wrote that a guard told him, “There’s so much damage to the Soviet government because of you that it would have been better if you had shot ten people.”

Prison guards are sometimes surprisingly frank in the Soviet Union; but if the Soviet authorities had been ready to respect individual dignity, the regime would not have been hurt by Koryagin in the first place. This is why if Gorbachev is now serious about improving the Soviet human rights situation and is not just freeing one or more dissidents to distract attention from the death of another, the liberation of Anatoly Koryagin is an obvious place to begin.

This Issue

February 12, 1987